VP Revenue Cycle Management - Affordable Care : Job Details

**Overview**

**Position Summary:**

The VP of RCM reports to the SVP of Insuranceer and is responsible for leading the full RCM team, which includes claims submission, overturning denials/rejections, reconciliation bank records with EOB and ensure AR is managed. This role is the primary contact for all 3 rd party insurance initiatives for internal ACI departments and the practices. Manages an internal team of 25+ and outsourced vendors.

**Responsibilities**

**Position Duties and Responsibilities** :

+ Manage and lead a team of employees, including developing a high performing team and assessing performance.

+ Ensure effective and timely contract administration and support.

+ Ensure KPIs for internal teams output for claims, % received, denials/rejections, and AR

+ Ensure SLAs for vendors are met and managed.

+ Monitor all process flows and provide feedback to improve processes and results.

+ Develop and maintain training modules on plan administration (patient eligibility, claims processing, posting payments, managing AR, outsourcing variations, etc.). Institute and monitor auditing mechanisms to ensure success.

+ Participate in cross-functional projects as the insurance service expert

+ Respond to practice team questions regarding RCM and AR.

+ Develop and maintain revenue cycle metric reports, managing to established benchmarks.

+ Perform other duties as new opportunities arise and/or as assigned. Demonstrate a strong work ethic, high sense of urgency and the passionate desire to drive results.

**Qualifications**

**Qualifications**

+ Ability to interpret and effectively communicate all aspects of RCM.

+ Excellent verbal and written communication skills.

+ Proven track record for managing RCM functions

+ Excellent problem-solving skills.

+ Well organized, accurate, and thorough.

+ Adaptable; readily adjusts work schedule to adhere to changes in the work environment and is able to manage competing demands.

+ Adept at prioritizing, planning work activities, and developing reasonable action plans.

+ Proficiency in all Microsoft Office products.

**Education and Experience Requirements:**

+ Bachelors degree required.

+ Minimum 8 to 10 years of RCM management.

**Computer Skills:**

+ Proficiency in a Microsoft Windows environment.

+ Proficiency with dental or medical software.

**Core Competencies:** To perform the job successfully, an individual should demonstrate the following competencies to perform the essential functions of this position.

+ Exemplary leadership skills.

+ High level of customer service orientation.

+ Ability to assess development needs of affiliated auxiliary practice staff.

+ Knowledgeable in creating and presenting training course material.

+ Must possess strong skills in the areas of interpersonal communication, analysis, critical thinking, attention to detail, multi-tasking, and oral & written communication.

+ Excellent verbal and written communication skills.

+ Ability to work independently and collaboratively within a team environment.

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**Job ID** _2024-28059_

**Category** _Other_